Tuesday, October 11, 2011

Washington state Medicaid limits emergency room visits not classified urgent; other states may follow

On Saturday, the state of Washington enacted a rule limiting the number of emergency-room visits it will cover for a Medicaid patient if the visit is not deemed an emergency. The rule, intended to keep costs under control, has many doctors concerned and the Washington Chapter of the American College of Emergency Physicians is suing the state to block the plan, Julian Pecquet of The Hill reports. Stephen Anderson, president of the Washington Chapter, said 19 other states are working to develop such a policy, and "If this plan goes into effect, other states will certainly follow."

The Washington rule limits Medicaid patients to three "non-emergency" visits per year and categorizes more than 700 diagnoses — including chest pain, abdominal pain, miscarriage and breathing problems — as "non-emergent," Pecquet reports. This puts hospitals that "are mandated by law to accept all emergency patients, regardless of ability to pay" in a tough spot, reports Sheila Hagar of the Walla Walla Union-Bulletin. "All that does is drive up the cost of health care for paying customers." (Read more) The emergency doctors' suit suggests the state did not meet requirements of the legislature because it failed to seek stakeholder comments before imposing the plan, Pecquet reports.

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